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Rien de Vos, RN; Hanneke C. J. M. de Haes, MS, PhD; Rudolph W. Koster, MD, PhD; Rob J. de Haan, RN, PhD

Arch Intern Med. 1999;159:249-254.

Background  Outcome of cardiopulmonary resuscitation (CPR) can be poor, in terms of life expectancy and quality of life.

Objectives  To determine the impact of patient characteristics before, during, and after CPR on these outcomes, and to compare results of the quality-of-life assessment with published studies.

Methods  In a cohort study, we assessed by formal instruments the quality of life, cognitive functioning, depression, and level of dependence of survivors after in-hospital CPR. Follow-up was at least 3 months after discharge from the hospital (tertiary care center).

Results  Of 827 resuscitated patients, 12% (n = 101) survived to follow-up. Of the survivors, 89% participated in the study. Most survivors were independent in daily life (75%), 17% were cognitively impaired, and 16% had depressive symptoms. Multivariate regression analysis showed that quality of life and cognitive function were determined by 2 factors known before CPR—the reason for admission and age. Factors during and after resuscitation, such as prolonged cardiac arrest and coma, did not significantly determine the quality of life or cognitive functioning of survivors. The quality of life of our CPR survivors was worse compared with a reference group of elderly individuals, but better than that of a reference group of patients with stroke. The quality of life did not importantly differ between the compared studies of CPR survivors.

Conclusions  Cardiopulmonary resuscitation is frequently unsuccessful, but if survival is achieved, a relatively good quality of life can be expected. Quality of life after CPR is mostly determined by factors known before CPR. These findings may be helpful in informing patients about the outcomes of CPR.

From the Resuscitation Committee (Drs de Vos and Koster), the Departments of Medical Psychology (Dr de Haes), Cardiology (Dr Koster), and Clinical Epidemiology and Biostatistics (Dr de Haan), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

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